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This study shows that an in-home virtual reality game delivering constraint-induced movement therapy (CI therapy) is a feasible and safe option for improving hand and arm function in people with chronic hemiparesis.

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Area of Science:

  • Neurorehabilitation
  • Rehabilitation Engineering
  • Virtual Reality in Medicine

Background:

  • Chronic hemiparesis often results in dissatisfaction with upper limb recovery.
  • Effective treatments like constraint-induced movement therapy (CI therapy) are not always accessible.
  • Novel delivery methods are needed to improve access to rehabilitation for hemiparesis.

Purpose of the Study:

  • To determine the feasibility of an in-home CI therapy model using a custom, avatar-based virtual reality (VR) game.
  • To measure the safety of this novel VR-based CI therapy intervention.
  • To assess the outcomes of VR-delivered CI therapy on arm function and use.

Main Methods:

  • A pretest/posttest quasi-experimental design was used with 17 individuals with chronic hemiparesis.
  • The 10-day intervention included high-repetition VR motor practice, constraint of the unaffected arm, and a transfer package.
  • Feasibility was assessed by comparing to traditional CI therapy and participant feedback. Primary outcomes included the Wolf Motor Function Test (WMFT) and Motor Activity Log (MAL-QOM).

Main Results:

  • Participants completed an average of 17.2 hours and 19,436 repetitions of motor practice.
  • No adverse events were reported during the intervention.
  • Significant improvements were observed in WMFT (Cohen's d=1.5) and MAL-QOM (Cohen's d=1.1), with 4 of 7 feasibility criteria met.

Conclusions:

  • The avatar-based VR game model for delivering CI therapy at home is feasible.
  • The intervention was well-received by participants and demonstrated preliminary safety.
  • This VR-based approach shows potential as a safe and effective rehabilitation tool for chronic hemiparesis.